Development of a "Myeloma Risk Score" using a population-based registry on paraproteinemia and myeloma.
Diagnostic systems for monoclonal gammopathies use bone marrow and X-ray examinations to exclude multiple myeloma (MM). Data from a population-based registry of unselected patients with paraproteinemia indicate that these tests are often done only when MM is suspected. We used 441 randomly selected patients to develop a simple four point "Myeloma Risk Score" based on two readily available laboratory tests. One point was given for paraprotein concentration > or = 10 g/l, one point for IgG and IgA, and two points for IgD and light chains only. A score of 0 or 1 indicated a low risk for MM, with scores of 2 and 3 signifying high risks. Sensitivity, specificity, positive and negative predictive value (PV) for the Myeloma Risk Score in the training sample were 92%, 88%, 79%, and 96% respectively. Extrapolating these results to a larger cohort showed that 90% of patients with a monoclonal gammopathy could be classified correctly as having MM or a non-myeloma condition. The Myeloma Risk Score can identify patients with a paraproteinemia at risk for MM, and who are therefore candidates for bone marrow and X-ray examination.
Ong
F
F
Comprehensive Cancer Centre West, Leiden, The Netherlands.
Hermans
J
J
Noordijk
E M
EM
De Kieviet
W
W
Seelen
P J
PJ
Wijermans
P W
PW
Kluin-Nelemans
J C
JC
D014408:Biomarkers, Tumor / Q000097:blood; D003937:Diagnosis, Differential; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007072:Immunoglobulin D / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D009101:Multiple Myeloma / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D010265:Paraproteinemias / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D012042:Registries; D018570:Risk Assessment; D012680:Sensitivity and Specificity
D014408:Biomarkers, Tumor; D007070:Immunoglobulin A; D007072:Immunoglobulin D; D007074:Immunoglobulin G